围产儿死亡151例分析  

Analysis of 151 cases of perinatal death

作　　者：周莹[1] 高劲松[1] 胡静[1] 戚庆伟[1] 周希亚[1] 宋英娜[1] 宋亦军[1] 马良坤[1] 蒋宇林[1] 刘俊涛[1] ZHOU Ying;GAO Jin-song;HU Jing;QI Qing-wei;ZHOU Xi-ya;SONG Ying-na;SONG Yi-jun;MA Liang-kun;JIANG Yu-lin;LIU Jun-tao(Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Science,Beijing　100730)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730

出　　处：《生殖医学杂志》2018年第4期299-304,共6页Journal of Reproductive Medicine

基　　金：国家科技支撑计划“临床医学研究协同网络建设示范应用研究(二)”(2015BAI13B04)

摘　　要：目的分析围产儿死亡的原因,以预防和减少围产儿死亡的发生。方法回顾性分析2010年1月1日至2016年12月31日,我院收治的孕周满28周的死胎死产及出生7d内新生儿死亡的151例患者的临床资料,对死亡原因进行分类及分析。结果 7年间围产儿死亡率为11.0‰,其中死胎死产89例(6.5‰),早期新生儿死亡62例(4.5‰)。各年度围产儿死亡率及死胎死产率、早期新生儿死亡率均在一个低水平波动。死胎死产的前三位死因分别为:母体疾病(38.0%)、脐带因素(19.7%)和胎盘因素(18.3%)。早期新生儿死亡的前三位死因分别为:母体疾病(62.7%)、胎儿因素(11.9%)和胎盘因素(11.9%)。结论我院围产儿死亡率稳定在相对低水平,主要死亡原因是母亲的妊娠并发症,特别是妊娠高血压疾病。对于死胎死产病例,建议行胎盘病理、尸检及分子细胞遗传学分析,推荐进行胎母输血(FMH)筛查,并选择性进行其他相关的检查。Objective:To analyze the etiolgies and risk factors of perinatal death,thus to prevent and reduce perinatal morbidity.Methods:The clinical data of 151 perinatal deaths which were the stillbirths in full 28 gestation weeks or the death of newborns within 7 days of birth in Peking Union Medical College Hospital from Jan.1,2010 to Dec.31 2016 were retrospectively analyzed.After their clinical data were reviewed,their etiologies were classified and analyzed.Results:The perinatal morbidity was 11.0‰during the 7 years period,with 6.5‰stillbirth rate(n=89)and 4.5‰early neonatal death rate(n=62).The annual perinatal mortality,the stillbirth rate and the early neonatal mortality were fluctuated at a low level.The first three causes of stillbirth were maternal complication(38.0%),umbilical cord factor(19.7%)and placenta factor(18.3%).As to the early neonatal death,maternal complication(62.7%),fetal factors(11.9%)and placenta factors(11.9%)were the leading three causes.Conclusions:The perinatal morbidity of our hospital was stabilized at relatively low levels.The leading causes of death were maternal complication,especially hypertensive disorder complicating pregnancy.Placental examination,autopsy,cytogenetic analysis,and fetal maternal hemorrhage tests are suggested as basic examination for fetal death workup.

关 键 词：围产儿死亡 死亡原因 死亡评估 

分 类 号：R714.7[医药卫生—妇产科学]